Provider Demographics
NPI:1790535144
Name:TRAN, PHIHUNG TAN (NP)
Entity Type:Individual
Prefix:
First Name:PHIHUNG
Middle Name:TAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:NP
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:7761 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4200
Mailing Address - Country:US
Mailing Address - Phone:714-898-8888
Mailing Address - Fax:714-908-8097
Practice Address - Street 1:7761 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4200
Practice Address - Country:US
Practice Address - Phone:714-898-8888
Practice Address - Fax:714-908-8097
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95026706363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health